NORWALK -- Fairfield County residents needing advanced cancer surgery now travel to New York City or elsewhere for care, according to Dan DeBarba Jr., Norwalk Hospital president and CEO.

That could change if Norwalk Hospital merges with Western Connecticut Health Network (WCHN), which operates Danbury and New Milford hospitals.

DeBarba says the proposed merger, announced last week, is about gaining customers by adding services and achieving efficiencies.

"It means that a person from Norwalk won't have to take that trip to New York City to get certain advanced surgeries after we're able to acquire those resources," DeBarba said. "We're going to share the cost with Danbury to bring those services to the market. It benefits both the citizens and residents of Danbury and Norwalk."

DeBarba wouldn't say if the merger will reduce costs for consumers, but he did say it will bring efficiencies at a time when Medicare, Medicaid and private insurers are not significantly increasing their payments to hospitals.

"In the future we will get paid not just for how many procedures we perform, but the quality of care provided," DeBarba said. "So I believe that we need to become more efficient so we can thrive in an environment where we get paid less."

In the coming weeks, Norwalk Hospital and WCHN will apply for merger approval from the state Attorney General's Office, the state Office of Health Care Access and the Federal Trade Commission (FTC).

Consumers suffered when Evanston Northwestern Healthcare Corp. of suburban Chicago merged with Highland Park Hospital, according to the FTC.

"The commission determined that it did increase costs to consumers," said Mitch Katz, FTC spokesman. "We went back and, over about four or five years, challenged that transaction and found that it was anticompetitive and they had to take some steps to address that."

But Katz and others caution against equating mergers with reduced competition.

Many factors come into play, including services offered, market size and insurance.

David S. Balto, a Washington, D.C.-based anti-trust attorney whose firm litigated the Evanston Northwestern case, said hospital mergers are complex rather than black and white.

In general, the lesser the distance between the merging hospitals, the greater the potential for consumers to lose, according to Balto.

"That's when you end up with problems. People would have to travel (elsewhere). They could raise prices," Balto said. "Hospital mergers often lead to higher prices, but they also, a good deal of the time, lead to improvements in the quality of care and often and typically are necessary to use facilities more efficiently and drive down costs."

Given the distance between Danbury and Norwalk, he doesn't anticipate problems.

"These guys don't sound like they're direct competitors," Balto said.

State Sen. Richard M. Blumenthal, former state attorney general, said he will do whatever he can to encourage "serious and prompt" FTC review of the proposed merger.

"This union will enable specialists to have access to more patients, as well as the hospitals themselves to perhaps cut unnecessary spending at a time when healthcare costs are spiraling astronomically," Blumenthal said. "These efficiencies could be very significant."

Katz, meanwhile, said the FTC does not comment on mergers until review is complete and a decision is issued. He did, however, speak generally.

"There can be efficiencies and there can be competitive problems and it's up to the FTC to sort them out," Katz said. "We don't prejudge transactions. We look at the papers and make a determination."